Ngongang OC¹, Chendjou KLO³, Mfeukeu-Kuate L, Azabji KM², Nganou CN², Hamadou¹, DjomouNAF³, BoombhiJ², Tsambang L¹, Wandji J¹, Jonte P¹, Bitchou M¹, Tachim K¹, Essono A¹, Kaze FJ¹,Ouankou MD¹, Kingue S², Ngu BK²

Authors’ affiliations

1. University Teaching Center of Yaounde
2. University of Yaounde I - Faculty of Medicine and Biomedical Sciences
3. Université Des Montagnes : Institut Supérieur des Sciences de la Santé (ISSS)

Abstract

Objective: To describe the epidemiological, clinical, therapeutical and evolutive patterns of super hypertension in Yaounde University Teaching Hospital.

Methods: This study is an observation cohort over a period of 9 months (January 2016 to September 2016). We recruited from members of the public who accepted voluntary blood pressure screening offered in various localities in Yaounde, and were aged 18 years or over.

Results: Of a total of 6.519 people, 1.875 (28.8%) presented a HBP. Amongst them, 37 presented a super hypertension (a systolic blood pressure 250 mmHg and/or diastolic blood pressure 150 mmHg in presence or not of complications), corresponding to a prevalence of 2% of all hypertensive patients. Our cohort comprised 33 of these individuals who accepted the invitation to participate in the study.  The mean age was 49.3 years, with a sex- ratio of 0.7. Twenty-three (70%) of the patients were known hypertensive for a mean time of 10 years, out of  9% were regularly rewieved, but none on medications. The mean of cardiovascular risk factors was 7, with 91% who had an excess salt intake. Dyspnea and headache were the main symptoms. The means systolic blood pressure and diastolic blood pressure were respectively 244.9 mmHg and 144.8 mmHg. Twenty-six (78.8) patients were either overweight or obese. We noticed a fundoscopy stage II or III in 21.1% of the cases. Seventy percent of the cases had left ventricular hypertrophy on electrocardiogram and 18.2 on echography. Complications were noticed on admission in 60.6% of all cases, it’s was mainly signs of renal failure. Acute kidney injury occurred in 15.15% of the cases during follow-up. The average rate of blood pressure control over 6 months was 3%. The main cause of poor blood pressure control was lack of therapeutic compliance.We noticed refractory high blood pressure in 4 (12.1%) cases and registered one death at the 3^rd month of follow up due to acute kidney injury.

Conclusion: Super hypertension is a youth’s pathology. Its early detection reduces significantly the high morbi-mortality. However, its efficient management needs minimal additional resources.